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Evaluation of the Cobra perilaryngeal airway (CPLA) as an airway conduit
- Source :
- European journal of anaesthesiology. 24(10)
- Publication Year :
- 2007
-
Abstract
- Background and Objective The effectiveness of the Cobra perilaryngeal airway as a routine airway device and as a conduit for tracheal intubation has not been prospectively studied to date. This study aimed to evaluate the Cobra perilaryngeal airway for its potential role in an emergency airway rescue, by analysing its use as a bridge to blind or fibre-optic-guided intubation. Methods In 49 patients, the procedure was carried out as follows: fibre-optic view through the Cobra perilaryngeal airway was assessed after the insertion of the Cobra perilaryngeal airway, then blind intubation through the Cobra perilaryngeal airway was attempted. After evaluating the success of blind intubation, fibre-optic-guided intubation was performed through the Cobra perilaryngeal airway. The endotracheal tube was removed after evaluating the success of fibre-optic-guided intubation, and then conventional laryngoscopy was carried out to evaluate the Cormack & Lehane grade and airway trauma. Results In all, 95.9% (47/49) of patients had adequate ventilation using the Cobra perilaryngeal airway; the success rates for the blind and fibre-optic-guided intubation were 36.2% and 83.0%, respectively. The patients were divided into two groups according to the fibre-optic view. Group 1 included patients with an obstructed view by an anterior grill of the Cobra perilaryngeal airway head, and a view of the anterior epiglottis (downfolded epiglottis) with or without a visible larynx (16/47, 34.0%). Group 2 included the remaining patients (31/47, 66.0%). The success rates of the blind and fibre-optic intubations were different between the two groups (blind intubation: 12.5% vs. 48.4%, fibre-optic intubation: 62.5% vs. 93.6%, P 0.05). 42.6% of patients had blood staining after removing the device and complications such as trauma and oedema were confirmed under direct laryngoscopy. Conclusion This study suggests that the Cobra perilaryngeal airway could be a useful airway device as a vehicle for fibre-optic-guided intubation; however, it needs caution against airway trauma.
- Subjects :
- Larynx
Adult
Male
Epiglottis
medicine.medical_specialty
medicine.medical_treatment
Laryngoscopy
Cobra
Anesthesia, General
Laryngeal Masks
medicine
Intubation, Intratracheal
Intubation
Fiber Optic Technology
Humans
Prospective Studies
Emergency Treatment
computer.programming_language
medicine.diagnostic_test
business.industry
Tracheal intubation
respiratory system
Middle Aged
Respiration, Artificial
Surgery
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Anesthesia
Female
business
Airway
computer
Subjects
Details
- ISSN :
- 02650215
- Volume :
- 24
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- European journal of anaesthesiology
- Accession number :
- edsair.doi.dedup.....de67cadcc69264ad9676be412eeb20c9